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Impact of Rotavirus Vaccination on Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia.
Clin Infect Dis. 2016 May 01; 62 Suppl 2:S183-7.CI

Abstract

BACKGROUND

Monovalent rotavirus vaccine was introduced in the routine public health immunization program in Lusaka, Zambia, in January 2012 and was rolled out countrywide in November 2013. We examined the effect of rotavirus vaccination on hospitalization for all-cause acute gastroenteritis (AGE) and rotavirus-specific AGE at a large referral hospital in Lusaka.

METHODS

Data were derived from ongoing hospital-based AGE surveillance from January 2009 to December 2014. Pre-rotavirus vaccine introduction (2009-2011) and post-rotavirus vaccine introduction (2013-2014) periods were compared for annual changes in hospitalizations for AGE and rotavirus; 2012 was excluded as a transition year. Hospital administrative discharge data were used to compare trends in all-cause diarrhea discharges and in-hospital diarrhea deaths captured by HIMS pre- and post-rotavirus vaccine introduction.

RESULTS

Between January 2009 and December 2014, 5937 children <5 years of age presenting with AGE had their stools collected and tested for rotavirus by enzyme immunoassay. The rotavirus positivity rate declined from 40.1% (449/1121) in prevaccine years to 30.2% (250/828;P< .001) in 2013 and 24.7% (157/635;P< .001) in 2014. The greatest reduction was noted in infants, with the rotavirus positivity rate in this age group declining from 40.9% in prevaccine years to 34.0% (P= .009) in 2013 and 26.2% (P< .001) in 2014. Following rotavirus vaccine introduction, seasonal peaks of rotavirus and all-cause AGE were dwarfed. From HIMS data, compared to the prevaccine era, reductions of 18%-29% in all-cause diarrhea hospitalizations and 27%-33% in-hospital diarrhea deaths among children <1 year of age were observed in 2013 and 2014.

CONCLUSIONS

We observed a significant reduction in AGE-associated in-hospital morbidity and mortality following rotavirus vaccine introduction. The greatest reduction was seen in infants <1 year who accounted for 84.4% of rotavirus hospitalizations prior to vaccine introduction.

Authors+Show Affiliations

Department of Paediatrics and Child Health.Virology Laboratory, University Teaching Hospital, Lusaka, Zambia.World Health Organization, Regional Office for Africa, Brazzaville, Republic of Congo.Virology Laboratory, University Teaching Hospital, Lusaka, Zambia.Virology Laboratory, University Teaching Hospital, Lusaka, Zambia.World Health Organization Country Office, Lusaka, Zambia.Centers for Disease Control and Prevention, Atlanta, Georgia.Centers for Disease Control and Prevention, Atlanta, Georgia.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

27059354

Citation

Mpabalwani, Evans M., et al. "Impact of Rotavirus Vaccination On Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 62 Suppl 2, 2016, pp. S183-7.
Mpabalwani EM, Simwaka CJ, Mwenda JM, et al. Impact of Rotavirus Vaccination on Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia. Clin Infect Dis. 2016;62 Suppl 2:S183-7.
Mpabalwani, E. M., Simwaka, C. J., Mwenda, J. M., Mubanga, C. P., Monze, M., Matapo, B., Parashar, U. D., & Tate, J. E. (2016). Impact of Rotavirus Vaccination on Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 62 Suppl 2, S183-7. https://doi.org/10.1093/cid/civ1027
Mpabalwani EM, et al. Impact of Rotavirus Vaccination On Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia. Clin Infect Dis. 2016 May 1;62 Suppl 2:S183-7. PubMed PMID: 27059354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of Rotavirus Vaccination on Diarrheal Hospitalizations in Children Aged <5 Years in Lusaka, Zambia. AU - Mpabalwani,Evans M, AU - Simwaka,Chibumbya J, AU - Mwenda,Jason M, AU - Mubanga,Cynthia P, AU - Monze,Mwaka, AU - Matapo,Belem, AU - Parashar,Umesh D, AU - Tate,Jacqueline E, PY - 2016/4/10/entrez PY - 2016/4/10/pubmed PY - 2016/12/29/medline KW - acute gastroenteritis KW - disease burden KW - impact KW - rotavirus vaccine SP - S183 EP - 7 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 62 Suppl 2 N2 - BACKGROUND: Monovalent rotavirus vaccine was introduced in the routine public health immunization program in Lusaka, Zambia, in January 2012 and was rolled out countrywide in November 2013. We examined the effect of rotavirus vaccination on hospitalization for all-cause acute gastroenteritis (AGE) and rotavirus-specific AGE at a large referral hospital in Lusaka. METHODS: Data were derived from ongoing hospital-based AGE surveillance from January 2009 to December 2014. Pre-rotavirus vaccine introduction (2009-2011) and post-rotavirus vaccine introduction (2013-2014) periods were compared for annual changes in hospitalizations for AGE and rotavirus; 2012 was excluded as a transition year. Hospital administrative discharge data were used to compare trends in all-cause diarrhea discharges and in-hospital diarrhea deaths captured by HIMS pre- and post-rotavirus vaccine introduction. RESULTS: Between January 2009 and December 2014, 5937 children <5 years of age presenting with AGE had their stools collected and tested for rotavirus by enzyme immunoassay. The rotavirus positivity rate declined from 40.1% (449/1121) in prevaccine years to 30.2% (250/828;P< .001) in 2013 and 24.7% (157/635;P< .001) in 2014. The greatest reduction was noted in infants, with the rotavirus positivity rate in this age group declining from 40.9% in prevaccine years to 34.0% (P= .009) in 2013 and 26.2% (P< .001) in 2014. Following rotavirus vaccine introduction, seasonal peaks of rotavirus and all-cause AGE were dwarfed. From HIMS data, compared to the prevaccine era, reductions of 18%-29% in all-cause diarrhea hospitalizations and 27%-33% in-hospital diarrhea deaths among children <1 year of age were observed in 2013 and 2014. CONCLUSIONS: We observed a significant reduction in AGE-associated in-hospital morbidity and mortality following rotavirus vaccine introduction. The greatest reduction was seen in infants <1 year who accounted for 84.4% of rotavirus hospitalizations prior to vaccine introduction. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/27059354/Impact_of_Rotavirus_Vaccination_on_Diarrheal_Hospitalizations_in_Children_Aged_<5_Years_in_Lusaka_Zambia_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/civ1027 DB - PRIME DP - Unbound Medicine ER -